Outcomes of patients with OHCA of presumed cardiac etiology that did not achieve prehospital restoration of spontaneous circulation: The All-Japan Utstein Registry experience

Atsunori Onoe, Kentaro Kajino, Mohamud R. Daya, Marcus Eng Hock Ong, Fumiko Nakamura, Mari Nakajima, Hiroki Takahashi, Masanobu Kishimoto, Kazuhito Sakuramoto, Takashi Muroya, Hitoshi Ikegawa, Yasuyuki Kuwagata

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Correct identification of futile prehospital resuscitation for out-of-hospital cardiac arrest (OHCA) may reduce unnecessary transports. Prehospital return of spontaneous circulation (ROSC) is considered by many to be an important predictor of outcome. The purpose of this study was to evaluate OHCA victims without prehospital ROSC characteristics and their outcomes in relation to the universal Termination of Resuscitation (TOR) rule. Methods: A retrospective, population-based review of OHCA victims without prehospital ROSC from January 1, 2010 to December 31, 2017 in the All-Japan Utstein Registry. We compared those that met the universal TOR rule and those that did not for the primary outcome: one-month survival with neurologically favorable Cerebral Performance Category (CPC) 1 or 2. Results: 989,929 OHCA cases, 18 years of age or older, were registered in the All-Japan Utstein Registry and 525,801 cases were of presumed cardiac origin and had no prehospital ROSC. Of these, the one-month CPC was 1 or 2 for 3957 cases (0.8%). In the ‘no ROSC’ group who also met the TOR rule, the number of cases was 433,571 with a one-month survival of 0.9% (3799 cases), and the proportion with a CPC 1or 2 was 0.2% (699 cases). Conclusions: Continued resuscitation and transport of cases with no field ROSC who fulfill the TOR rule is futile and could be considered for adoption in Japan.

Original languageEnglish (US)
Pages (from-to)245-250
Number of pages6
JournalResuscitation
Volume162
DOIs
StatePublished - May 2021

Keywords

  • Cerebral performance category
  • Out-of-hospital cardiac arrest
  • Outcome
  • Termination of Resuscitation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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